What are the nursing actions in acute respiratory care regarding oxygen therapy for a patient known to have COPD?

For a patient known to have COPD, oxygen therapy in acute respiratory care should be used only with medical advice. The nurse administers oxygen as required to maintain a comfortable respiratory rate and oxygen saturation above 95%, while monitoring for signs of CO2 retention such as flushing, a bounding pulse, drowsiness, confusion, and rising heart rate and blood pressure. Nebulized drugs should be driven with medical air until the risk of type II respiratory failure has been assessed by a clinician.

Oxygen is a medical gas that should be prescribed and is indicated only for hypoxaemia. In acute respiratory care, nurses caring for a person known to have COPD should not give oxygen without medical advice. When oxygen is given, it should be administered as required to keep the patient's respiratory rate comfortable and oxygen saturation above 95%. Because people with COPD are at risk of carbon dioxide retention, fixed-performance Venturi-type delivery devices are used in acutely ill patients to provide a precise oxygen concentration and reduce unpredictable oxygen dosing. The nurse should watch for acute hypercapnia, recognised by a flushed facial appearance, bounding pulse, worsening drowsiness or confusion, and increased heart rate and blood pressure, and should treat this as a medical emergency. If nebulized bronchodilators are prescribed, they should be driven by medical air until a clinician has assessed the patient's risk of type II respiratory failure. Fire safety must also be maintained while oxygen is in use.